Men Need Care Too

April 14, 2017
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One night nearly a year ago, Christopher Edgar—a financial services professional in Los Angeles—got extremely lucky. While he brushed his teeth, the 33-year-old just happened to glance in the mirror and notice a small lump in his throat. “The lump was only visible when I swallowed,” says Edgar.

Edgar had a health care provider he trusted. Two years prior he’d visited Mehran Movassaghi, MD, a men’s health specialist. After a quick call to Dr. Movassaghi, Edgar was in his office the next day.

Edgar’s story is particularly noteworthy because of one key fact: He saw a doctor quickly. Men, especially young men, are notorious for not seeking medical attention or waiting far too long.

“As men, we often think we’re invincible or that going to the doctor is a sign of weakness,” says Dr. Movassaghi, a urologist at Providence Saint John’s Health Center and director of their Men’s Health Program. He notes a 2014 study that looked at health care utilization and found some interesting gender-based patterns.

According to the study, males and females were equal users of health care until approximately age 18 (about the time parents stop taking kids to doctors). From age 18 to sometime in their 50s, though, the typical male’s health care usage dropped to about 50% of what a typical female used. However, by the time a man hit 65, the average guy spent more health care dollars than the average woman and had a 10-year lower life expectancy.

“As men, we often think we’re invincible or that going to the doctor is a sign of weakness.” – Dr. Mehran Movassaghi

Dr. Movassaghi says men are too often missing opportunities for early intervention. “Those pivotal years of early adulthood is of­ten where we can actually make changes that will affect us when we’re older. These are the years that, research tells us, we are usually away from any health care services. Unfor­tunately, when problems finally arise many years later, it’s sometimes too late,” he says.

But not for Christopher Edgar, who with Dr. Movassaghi’s guidance quickly saw spe­cialists who diagnosed and treated him for thyroid cancer. “Working with Dr. Movas­saghi was just a different kind of health con­nection,” says Edgar. “I know that had I not had this relationship, I would’ve done what many guys my age would do: just ignore the bump and believe it was going to go away.”

Patients like Edgar are what keep Dr. Movassaghi motivated. He attended the University of California, Los Angeles, and earned a medical degree and MBA simulta­neously, then trained in urological disorders and surgery at Stanford, USC and Cedars- Sinai Medical Center. Dr. Movassaghi says his background sets him up perfectly to be a trailblazer in bringing comprehensive health care to men.

He has offices at Providence Saint John’s Health Center and will also care for patients at the Health Center’s new outpatient offices in Playa Vista when that facility opens in the spring of 2017.“I think the business training combined with medicine allows me to look at health care through the lens of fulfilling a real need in the community,” he says.

While he looked around and saw medical centers dedicated to women, the concept of a comprehensive health center for men hasn’t been as prevalent. His aim now is to con­vince more men to access health care earlier, getting “well-man care” and male-specific care for issues such as erectile dysfunction, low testosterone, prostate problems and more. One of Dr. Movassaghi’s most import­ant missions, though, is education.

“The word ‘doctor’ actually comes from the Greek word for teacher,” he notes. “I look at my role not as just a clinician or sur­geon but more importantly a teacher. Many doctors forget that most of our patients may not even be able to point to where their kidneys are in their body.”

An educated patient, according to Dr. Mo­vassaghi, is a patient who feels in control. This, he says, is the key to making the Providence Saint John’s Men’s Health Program successful.

“Being sick, whether it be life-threaten­ing like cancer or something as minor as the common cold, already makes someone vulnerable. If I just mandate the plan of care without allowing my patient to make his own decisions, then I’m just adding to his level of anxiety and vulnerability. So I take the ap­proach of guiding my patient. I let him know what I would do for myself or my family, but I always let him make his own decisions.”

“To treat a man effectively means understanding his needs, his concerns and how best to reach out to him.” – Dr. Mehran Movassaghi

The Men’s Health Program is already pro­viding highly efficient, convenient, tech-savvy care for all things men’s health. Dr. Movas­saghi has put together a men’s health advi­sory board which brings together providers from multiple specialties and background to ensure the care the center provides is cutting edge, and referrals amongst providers is seamless to the patients.

While urinary complaints, prostate issues and erectile dysfunction all fall within Dr. Movassaghi’s specialty of urology, they are all also connected with conditions that require a thorough assessment and health maintenance program. Erectile dysfunction, for example, is just as much a cardiovascular disease as it is a urologic problem.

According to Dr. Movassaghi, studies have shown that up to 40% of men have some level of erectile dysfunction by the time they turn 40. The same group of men is up to eight times more likely to have a heart attack in the following 10 years than those without erectile dysfunction. And men with erectile dysfunction tend to also have more problems with depression and hormone imbalances.

“So treatment of something like erectile dysfunction needs to involve assessment of cardiovascular health and risk, mood, hor­mones and lifestyle. Giving a pill may make the symptoms go away temporarily, but we don’t want to lose our chance to intervene and prevent much more serious health con­sequences,” says Dr. Movassaghi.

The point of the Men’s Health Program is to give a thorough look at the whole guy so he always gets optimal results. The center serves as a connector for men to quickly get the information and specialty care they need. In the case of Christopher Edgar, that was an endocrinologist and surgeon who specialized in thyroid cancer. But other men might be referred to any one of a network of physicians, surgeons, dieticians and thera­pists, including Saint John’s Health Center’s large roster of top-ranked cardiologists, oncologists, neurologists, orthopedists and other specialists.

“Every clinician we work with under­stands our philosophy. That is, that to treat a man effectively means understanding his needs, his concerns and how best to reach out to him.” For example, the program works with patients to minimize time away from work, offers patients screenings they can do in their free time and books appoint­ments with specialists expeditiously.

The center embraces technology. “I try to incorporate technology into every aspect of the center,” says Dr. Movassaghi. Staff mem­bers guide most patients through sign-up in an electronic medical portal called MyChart even before they meet the doctor.

“I then send all the intake and screening tools to them at home either through the por­tal, e-mail or fax and allow them to fill out our forms on their own schedule,” says the doctor. Patients send the information back, and Dr. Movassaghi and staff review the information and input it into their medical records before the appointment. “By the time you come in the door we already know a lot about you. That makes the appointment more efficient.”

And in terms of the treatments offered, the center offers the latest in terms of robotic, en­doscopic and minimally invasive techniques.

“Many of the major ailments in men— whether it be urologic, cardiovascular or endocrinologic—are a reflection of genetics, environment and lifestyle,” he says. “There are certain things we can modify to lower the risk of developing disease, while other things—our genes, for example—we aren’t able to change. The most important thing in prevention is identifying the underlying risk factors and optimizing the things that are able to be changed.”

Dr. Movassaghi tries to be a role model for his patients. He works out at least five days a week, preferring running, high-intensity interval training (HIIT), yoga and strength training at the gym.

“I always talk to my patients about being active and have actually created a program with the physical therapists here at Saint John’s to help people get moving,” he says.

And when something can’t be changed, as was the case with Christopher Edgar, Dr. Movassaghi makes sure treatment is swift and effective. “I feel like somebody was there to look out for my health and make sure I got in touch with the right treatment,” says Edgar, who recovered from his illness and is now busy training for triathlons. “To me, going to Dr. Movassaghi was a lifesaver.”


WellManExam

WHAT IS A WELL MAN EXAM?

Every adult woman has heard of “well woman” exams. It’s part of regular preventive care. The idea of a “well man” exam has not received as much attention. But it’s just as important to promote good health and wellbeing. Here’s what such an exam generally focuses on:

  • Physical examination, body mass index screening and blood pressure screening
  • Diet and exercise habits
  • History of substance use
  • Risk factors for sexually transmitted infections
  • Symptoms of depression
  • Tests for cholesterol and diabetes as needed
  • Tests for hormonal imbalances including thyroid disorders and sexual dysfunction
  • Immunizations as needed
  • Cancer screenings (prostate, colorectal, skin, testicular cancer) depending on age and risk factors
  • Other screening tests, such as abdominal aortic aneurism and bone density testing, depending on age and risk factors

Source: American Family Physician